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Practice Management Alert

Reader Question:

Your Checklist for Clean Collections

Published on Wed Jan 01, 2003

Question: I want a simple checklist to post on my desk, to give to new billers and to remind myself of all the steps to a clean claim. Do you have any suggestions about what should be on my list and in what order?

California Subscriber

Answer: Avoid denials, returns and delays by sending in clean claims the first go-round. This checklist will guide your office to smooth sailing. Post it over your desk to remind yourself of the importance of each step or to help new billers. Tips were contributed by expert office manager Victoria Jackson, administrator and CEO of Southern Orange County Pediatric Associates in Lake Forest, Calif.

  • Make sure the policy number and ID number are accurate.
  • Obtain insurance eligibility verification.
  • Verify other patient information: proper name, birth date, address.
  • Confirm information that the provider gave you for posting charged entries.
  • Check that CPT codes are up-to-date.
  • Make sure your ICD-9 codes are as specific as possible.
  • Ensure that your provider information is correct: provider identification, license number, group tax ID number, and UPIN.
  • Make sure, if applicable, that you have the referral authorization number on the form and that you have a referring physician's UPIN or HPI number if the carrier requires it.

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